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  1 / 2030 MEDLINE  
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[PMID]:28453822
[Au] Autor:Berian JR; Thomas JM; Minami CA; Farrell PR; O'Leary KJ; Williams MV; Prachand VN; Halverson AL; Bilimoria KY; Johnson JK
[Ad] Endereço:Illinois Surgical Quality Improvement Collaborative (ISQIC), 633 N. St Clair St., 20th Floor, Chicago, IL 60611, USA.
[Ti] Título:Evaluation of a novel mentor program to improve surgical care for US hospitals.
[So] Source:Int J Qual Health Care;29(2):234-242, 2017 Apr 01.
[Is] ISSN:1464-3677
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective: To evaluate a novel mentor program for 27 US surgeons, charged with improving quality at their respective hospitals, having been paired 1:1 with 27 surgeon mentors through a state-wide quality improvement (QI) initiative. Design: Mixed-methods utilizing quantitative surveys and in-depth semi-structured interviews. Setting: The Illinois Surgical Quality Improvement Collaborative (ISQIC) utilized a novel Mentor Program to guide surgeons new to QI. Participants: All mentor-mentee pairs received the survey (n = 27). Purposive sampling identified a subset of mentors (n = 8) and mentees (n = 4) for in-depth semi-structured interviews. Intervention: Surgeons with expertise in QI mentored surgeons new to QI. Main outcome measures: (i) Quantitative: self-reported satisfaction with the mentor program; (ii) Qualitative: key themes suggesting actions and strategies to facilitate mentorship in QI. Results: Mentees expressed satisfaction with the mentor program (n = 24, 88.9%) and agreed that mentorship is vital to ISQIC (n = 24, 88.9%). Analysis of interview data revealed four key themes: (i) nuances of data management, (ii) culture of quality and safety, (iii) mentor-mentee relationship and (iv) logistics. Strategies from these key themes include: utilize raw data for in-depth QI understanding, facilitate presentations to build QI support, identify opportunities for in-person meetings and establish scheduled conference calls. The mentor's role required sharing experiences and acting as a resource. The mentee's role required actively bringing questions and identifying barriers. Conclusions: Mentorship plays a vital role in advancing surgeon knowledge and engagement with QI in ISQIC. Key themes in mentorship reflect strategies to best facilitate mentorship, which may serve as a guide to other collaboratives.
[Mh] Termos MeSH primário: Mentores
Melhoria de Qualidade/organização & administração
Cirurgiões/psicologia
Centro Cirúrgico Hospitalar/normas
[Mh] Termos MeSH secundário: Comportamento Cooperativo
Feminino
Seres Humanos
Relações Interprofissionais
Masculino
Satisfação Pessoal
Avaliação de Programas e Projetos de Saúde
Inquéritos e Questionários
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/intqhc/mzx005


  2 / 2030 MEDLINE  
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[PMID]:28449093
[Au] Autor:Mokhles S; Maat APWM; Aerts JGJV; Nuyttens JJME; Bogers AJJC; Takkenberg JJM
[Ad] Endereço:Department of Cardiothoracic Surgery, Erasmus MC, Rotterdam, Netherlands.
[Ti] Título:Opinions of lung cancer clinicians on shared decision making in early-stage non-small-cell lung cancer.
[So] Source:Interact Cardiovasc Thorac Surg;25(2):278-284, 2017 08 01.
[Is] ISSN:1569-9285
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To investigate the opinions of lung cancer clinicians concerning shared decision making (SDM) in early-stage non-small-cell lung cancer patients. METHODS: A survey was conducted among Dutch cardiothoracic surgeons and lung surgeons, pulmonologists and radiation oncologists. The opinions of clinicians on the involvement of patients in treatment decision making was assessed using a 1-5 Likert-type scale. Through open questions, we queried barriers to and drivers of SDM in clinical practice. Clinicians were asked to review 7 hypothetical cases and indicate which treatment strategy they would choose using a 1-7 Likert-type scale. RESULTS: Twenty-six percent of surgeons, 20% of pulmonologists and 12% of radiation oncologists indicated that they always engage in SDM (16% missing; P-value = 0.10). Most respondents stated that, ideally, doctors and patients should decide together (surgeons 52%, pulmonologists 67% and radiation oncologists 35%; P-value = 0.005). Thirty percent of surgeons, 27% of pulmonologists and 44% of radiation oncologists indicated that doctors are not properly trained to implement SDM in clinical practice (P-value = 0.37). SDM may not always be feasible due to low patient education level and minimal knowledge about lung cancer. Wide variations in the clinicians' lung cancer treatment preferences were observed in the responses to the hypothetical cases. CONCLUSIONS: In current clinical decision making in lung cancer treatment, a majority of clinicians agree that it is important to involve lung cancer patients in treatment decision making but that time constraints and the inability of some patients to make a weighted decision are important barriers. The observed variation in lung cancer treatment preferences among clinicians suggests that for most patients both surgery and radiotherapy are suitable options, and it underlines the sensitive nature of treatment choices in early-stage non-small-cell lung cancer.
[Mh] Termos MeSH primário: Carcinoma Pulmonar de Células não Pequenas/diagnóstico
Tomada de Decisões
Diagnóstico Precoce
Neoplasias Pulmonares/diagnóstico
Estadiamento de Neoplasias/métodos
Participação do Paciente
Pneumonectomia
[Mh] Termos MeSH secundário: Adulto
Carcinoma Pulmonar de Células não Pequenas/cirurgia
Feminino
Seres Humanos
Neoplasias Pulmonares/cirurgia
Masculino
Meia-Idade
Preferência do Paciente
Relações Médico-Paciente
Cirurgiões
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1093/icvts/ivx103


  3 / 2030 MEDLINE  
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[PMID]:29428043
[Au] Autor:Golob JF; Como JJ; Claridge JA
[Ti] Título:Trauma Surgeons Save Lives-Scribes Save Trauma Surgeons!
[So] Source:Am Surg;84(1):144-148, 2018 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:With the advent of the electronic medical record, the documentation burden of the trauma surgeon has become overwhelming. To help, our trauma division added scribes to the rounding team. We hypothesized that scribe utilization would improve our documentation efficiency and offer a financial benefit to the institution. A review of trauma surgeon documentation and billing was performed at a Level I trauma center over two time periods: January to May 2014 (no scribes) and January to May 2015 (scribes). The number of notes written by trauma surgeons was obtained, as were documentation charges. Documentation efficiency was determined by noting both the hour of the day in which inpatient progress notes were written and the number of notes written after patient discharge. In the 2014 period, a total of 9726 notes were written by trauma attendings. In the 2015 period, 10,933 were written. Despite having 407 fewer trauma patient-days in the 2015 period, the group wrote 343 notes/week versus 298 notes/week (P = 0.008). More inpatient progress notes were written earlier in the working day and fewer were written in the evening. Fewer notes were written after patient discharge (12.7 vs 8.4%). A total of 1,664 hours of scribe time were used over the 5-month period, generating an expense of $32,787. The additional notes generated by scribes resulted in $191,394 in charges. Conservatively, assuming a 20 per cent charge reimbursement, the cost of the scribes was covered. The addition of scribes to the daily trauma rounding team improved note efficiency and increased charge capture at our center.
[Mh] Termos MeSH primário: Custos e Análise de Custo/economia
Documentação/economia
Registros Eletrônicos de Saúde
Preços Hospitalares
Administradores de Registros Médicos/economia
Centros de Traumatologia/economia
Centros de Traumatologia/recursos humanos
[Mh] Termos MeSH secundário: Registros Eletrônicos de Saúde/economia
Registros Eletrônicos de Saúde/normas
Seres Humanos
Pacientes Internados
Alta do Paciente
Cirurgiões/economia
Estados Unidos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180212
[St] Status:MEDLINE


  4 / 2030 MEDLINE  
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[PMID]:29428011
[Au] Autor:Rubenstein R; Cowan SW; Yeo CJ; Entwistle JW
[Ti] Título:René Gerónimo Favaloro (1923-2000): A Man Who Struggled with Matters of the Heart.
[So] Source:Am Surg;84(1):7-11, 2018 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:René Gerónimo Favaloro prided himself on being a "simple country doctor." Born in La Plata, Argentina, Dr. Favaloro had an interest in Argentina's sociopolitical and healthcare systems beginning at a young age. He began his medical education at La Universidad Nacional de La Plata, graduating in 1949 with plans to continue his medical education in the field of surgery; however, in 1950, Dr. Favaloro temporarily resigned from his position as a surgeon to work as a country doctor in a small province of La Pampa, Argentina. It was during this time that Dr. Favaloro became acutely aware of the overwhelmingly poor state of the healthcare system in Argentina. In 1962, Dr. Favaloro redirected his focus back to his surgical interests and moved to the United States to work at the Cleveland Clinic, where he discovered the use of the saphenous vein graft for revascularization of the coronary arteries. Despite a productive medical career in the United States, Dr. Favaloro eventually brought his work back to Argentina, where his heart had always remained. Throughout the incredible milestones of his life, Dr. René Gerónimo Favaloro consistently remained a humble, gracious, and simple country doctor.
[Mh] Termos MeSH primário: Cardiologia/história
Ponte de Artéria Coronária/história
Assistência à Saúde/história
Metáfora
Veia Safena
Cirurgiões/história
[Mh] Termos MeSH secundário: Argentina
Educação Médica/história
História do Século XX
Seres Humanos
Masculino
Editoração/história
Veia Safena/transplante
Estados Unidos
[Pt] Tipo de publicação:BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE; PORTRAITS
[Ps] Nome de pessoa como assunto:Favaloro RG
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180212
[St] Status:MEDLINE


  5 / 2030 MEDLINE  
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[PMID]:28456358
[Au] Autor:Weinheimer KT; Smuin DM; Dhawan A
[Ad] Endereço:Department of Orthopaedic Surgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, U.S.A.. Electronic address: kentwein2007@gmail.com.
[Ti] Título:Patient Outcomes as a Function of Shoulder Surgeon Volume: A Systematic Review.
[So] Source:Arthroscopy;33(7):1273-1281, 2017 Jul.
[Is] ISSN:1526-3231
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To examine surgical complications, length of stay, surgical time, cost, revision rates, clinical outcomes, current surgical trends. and minimum number of cases in relationship to surgeon volume for shoulder arthroplasty and rotator cuff repair. METHODS: We performed a systematic review of studies using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All studies that met inclusion criteria from January 1990 to January 2016 were included. Inclusion criteria included Level IV evidence or greater, contained specific surgeon volume, and were written in or translated into English. Exclusion criteria included non-English manuscripts, abstracts, and review papers. A written protocol was used to extract relevant data and evaluate study results. Data extracted included volume-specific data pertaining to length of stay, operating time, complications, and cost. RESULTS: A total of 10 studies were included. Seven studies evaluated arthroplasty with 88,740 shoulders, and 3 studies evaluated rotator cuff repair with 63,535 shoulders. Variation was seen in how studies defined low- versus high-volume surgeon. For arthroplasty, <5 cases per year met the criteria for a low-volume surgeon and were associated with increased length of stay, longer operating room time, increased in-hospital complications, and increased cost. Mortality was not significantly increased. In rotator cuff surgery, <12 surgeries per year met the criteria for low volume and were associated with increased length of stay, increased operating room time, and increase in reoperation rate. CONCLUSIONS: Our systematic review demonstrates increased surgical complications, length of stay, surgical time, and surgical cost in shoulder arthroplasty and rotator cuff repair when performed by a low-volume shoulder surgeon, which is defined by those performing <5 arthroplasties and/or <12 rotator cuff repairs per year. LEVEL OF EVIDENCE: Level III, systematic review of Level II and III studies.
[Mh] Termos MeSH primário: Artroplastia/normas
Artroscopia/normas
Padrões de Prática Médica/estatística & dados numéricos
Lesões do Manguito Rotador/cirurgia
[Mh] Termos MeSH secundário: Artroplastia/estatística & dados numéricos
Artroscopia/estatística & dados numéricos
Seres Humanos
Cirurgiões
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


  6 / 2030 MEDLINE  
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[PMID]:29351923
[Au] Autor:Humm GL; Sutton P; Gokani V; Mohan H; Association of Surgeons in Training
[Ad] Endereço:Association of Surgeons in Training, London WC2A 3PE, UK.
[Ti] Título:Association of Surgeons in Training responds to GMC erasure case.
[So] Source:BMJ;360:k224, 2018 01 19.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Má Conduta Profissional
Cirurgiões
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180121
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k224


  7 / 2030 MEDLINE  
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[PMID]:29283524
[Au] Autor:Van Hee R
[Ti] Título:The Influence of Vesalius' Fabrica on Surgery in the 16th & 17th century.
[So] Source:Vesalius;22(1):8-28, 2016 Jun.
[Is] ISSN:1373-4857
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:The innovation in anatomy, brought about by Andreas Vesalius1, particularly by means of his Fabrica, has had an important influence on the practice of surgery2. Various surgeons of the 16th and the 17th century have implemented different approaches in operative techniques, based on the anatomical knowledge drawn upon the Fabrica. Examples are given in this paper concerning Pierre Franco, Ambroise Paré, Giovanni Andrea della Croce, Girolamo Fabrici d'Acquapendente, Wilhelm Fabry von Hilden and Paul Barbette, who all, in one way or another, have proposed surgical techniques that required precise anatomical understanding, which was provided by the new Vesalian anatomy of the human body. The concept, adopted by many medico-historical scholars, that the anatomy of Vesalius had only limited repercussions on Modern Surgery, therefore needs reconsideration.
[Mh] Termos MeSH primário: Cirurgia Geral/história
Cirurgiões/história
Livros de Texto como Assunto/história
[Mh] Termos MeSH secundário: França
Alemanha
História do Século XVI
História do Século XVII
Seres Humanos
Itália
Países Baixos
[Pt] Tipo de publicação:BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE; PORTRAITS
[Ps] Nome de pessoa como assunto:Franco P; Pare A; della Croce GA; Fabrici d'Acquapendente G; Fabry von Hilden W; Barbette P; Vesalius A
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:QIS
[Da] Data de entrada para processamento:171229
[St] Status:MEDLINE


  8 / 2030 MEDLINE  
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[PMID]:29283541
[Au] Autor:Thinard-Morel J
[Ti] Título:[In process]
[Ti] Título:Alimentation et soins des maladies de I'Hotel-Dieu de Paris à l'èpoque moderne..
[So] Source:Vesalius;22(2):44-53, 2016 Dec.
[Is] ISSN:1373-4857
[Cp] País de publicação:Belgium
[La] Idioma:fre
[Ab] Resumo:At the end of the Middle Ages, in 1492, the Hôtel-Dieu de Paris was still and establishment of charity intended to receive thepoor which came there to find a shelter and some food. Three centuries later, just before the French Revolution, it became an establishment of care mainly destined to receive the patients, to feed them, take care of them and if possible cure them. This medicalization of the Hôtel-Dieu de Paris is related to the progressive emergence of the medical function, which resulted in the creation and the development of a doctor's and surgeon's profession, but also in the development of the apothecary and its drugs. In this context, the diet plays a central part, because it happens to supplies. It would not be until the eve of the French Revolution that it would be integrated in the doctor's prescription and became a dietetic item.
[Mh] Termos MeSH primário: Hospitais Municipais/história
Médicos/história
[Mh] Termos MeSH secundário: Dieta/história
História do Século XVIII
Seres Humanos
Paris
Preparações Farmacêuticas/história
Farmácia/história
Cirurgiões/história
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Pharmaceutical Preparations)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:QIS
[Da] Data de entrada para processamento:171229
[St] Status:MEDLINE


  9 / 2030 MEDLINE  
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[PMID]:29260896
[Au] Autor:Whitaker M
[Ad] Endereço:Department of Economics, Mathematics and Statistics, Birkbeck University of London , London , UK.
[Ti] Título:The surgical personality: does it exist?
[So] Source:Ann R Coll Surg Engl;100(1):72-77, 2018 Jan.
[Is] ISSN:1478-7083
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Introduction This study aims to answer the question of whether surgeons have different personalities to non-surgeons. Methods Members of the Royal College of Surgeons of England were sent an email survey containing 50 standard questions from the Five Factor personality assessment, which scores each respondent in five key personality traits (conscientiousness, agreeableness, neuroticism, openness, extroversion). Results were analysed and compared with a population-level data set from a survey conducted by the BBC. Results Five hundred and ninety-nine surgeons completed the survey. Analysis showed that surgeons scored significantly higher for conscientiousness, agreeableness, openness and neuroticism than non-surgeons (P < 0.05). Further analysis showed that female surgeons scored higher in openness and extroversion relative to the population average and that surgeons become more prone to neuroticism than non-surgeons as they age. Conclusions The results support the notion of a surgical personality, as well as indicating that female surgeons have significantly different personality profiles from male surgeons, and that age affects surgeons' personalities in different ways to non-surgeons.
[Mh] Termos MeSH primário: Determinação da Personalidade
Personalidade
Cirurgiões/psicologia
Cirurgiões/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Modelos Psicológicos
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.1308/rcsann.2017.0200


  10 / 2030 MEDLINE  
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[PMID]:29280888
[Au] Autor:Khansa I; Khansa L; Westvik TS; Ahmad J; Lista F; Janis JE
[Ad] Endereço:Columbus, Ohio; Blacksburg, Va.; Skien, Norway; and Toronto, Ontario, Canada From the Department of Plastic Surgery, The Ohio State University Wexner Medical Center; the Department of Business Information Technology, Pamplin College of Business, Virginia Tech; the Division of Plastic Surgery, Telemark Hospital; and the Division of Plastic and Reconstructive Surgery, University of Toronto.
[Ti] Título:Work-Related Musculoskeletal Injuries in Plastic Surgeons in the United States, Canada, and Norway.
[So] Source:Plast Reconstr Surg;141(1):165e-175e, 2018 01.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Musculoskeletal injuries are more common among surgeons than among the general population. However, little is known about these types of injuries among plastic surgeons specifically. The authors' goals were to evaluate the prevalence, nature, causes, and potential solutions of these musculoskeletal injuries among plastic surgeons in three different countries: the United States, Canada, and Norway. METHODS: A survey was e-mailed to plastic surgeons in the United States, Canada, and Norway, soliciting their demographics, practice description, history of musculoskeletal issues, potential causes of these symptoms, and proposed suggestions to address these injuries. The prevalence of various musculoskeletal symptoms was calculated, and predictors of these symptoms were evaluated using multivariate logistic regression. RESULTS: The survey was sent to 3314 plastic surgeons, with 865 responses (response rate, 26.1 percent); 78.3 percent of plastic surgeons had musculoskeletal symptoms, most commonly in the neck, shoulders, and lower back. U.S. surgeons were significantly more likely to have musculoskeletal symptoms than Norwegian surgeons (79.5 percent versus 69.3 percent; p < 0.05); 6.7 percent of all respondents required surgical intervention for their symptoms. The most common causative factors were long surgery duration, tissue retraction, and prolonged neck flexion. The most common solutions cited were core-strengthening exercises, stretching exercises, and frequent adjustment of table height during surgery. CONCLUSIONS: Plastic surgeons are at high risk for work-related musculoskeletal injuries. Ergonomic principles can be applied in the operating room to decrease the incidence and severity of those injuries, and to avoid downstream sequelae, including the need for surgery.
[Mh] Termos MeSH primário: Saúde do Trabalhador
Traumatismos Ocupacionais/epidemiologia
Inquéritos e Questionários
Ferimentos e Lesões/etiologia
[Mh] Termos MeSH secundário: Adulto
Canadá/epidemiologia
Estudos Transversais
Feminino
Seres Humanos
Incidência
Internacionalidade
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Doenças Musculoesqueléticas/epidemiologia
Doenças Musculoesqueléticas/etiologia
Doenças Musculoesqueléticas/fisiopatologia
Noruega/epidemiologia
Traumatismos Ocupacionais/etiologia
Traumatismos Ocupacionais/fisiopatologia
Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos
Procedimentos Cirúrgicos Reconstrutivos/métodos
Cirurgiões/estatística & dados numéricos
Cirurgia Plástica/efeitos adversos
Cirurgia Plástica/métodos
Estados Unidos/epidemiologia
Ferimentos e Lesões/epidemiologia
Ferimentos e Lesões/fisiopatologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180117
[Lr] Data última revisão:
180117
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003961



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